Acute concussion is a common injury that affects children and adolescents, particularly those who participate in sports. Concussions are classified as a mild traumatic brain injury (mTBI) that can result from a blow to the head or body that causes the head to move rapidly. The symptoms of concussion can be physical, cognitive, or emotional and typically resolve within 7-10 days.

However, some children may experience prolonged symptoms that can impact their daily lives, including their ability to return to school. There is growing evidence that early return to school following an acute concussion may be associated with a more prolonged recovery and more severe symptoms. 

The purpose of this article is to examine the current research on the association between early return to school following an acute concussion.

The Importance of Rest After Concussion

The first step in the management of an acute concussion is rest, both physically and cognitively. Physical rest refers to reducing physical activity, including sports and other forms of exercise. Cognitive rest refers to reducing activities that require a lot of mental effort, such as reading, using the computer, and doing homework.

The importance of rest after an acute concussion is based on the principle that the brain needs time to recover from the injury. When the brain is injured, it is less able to process information, and this can result in symptoms such as headache, dizziness, and fatigue. By reducing physical and cognitive activity, the brain can conserve energy and focus on healing.

The Association Between Early Return to School and Prolonged Recovery

There is an evidence that early return to school following an acute concussion may be associated with a more prolonged recovery and more severe symptoms

A study published in the Journal of Pediatrics in 2019 found that children who returned to school within one week of their concussion were more likely to experience symptoms such as headache, dizziness, and fatigue compared to children who returned to school after two weeks. The study also found that children who returned to school early were more likely to miss additional school days and experience more difficulty with schoolwork.

Another study published in the Journal of Neurotrauma in 2018 found that early return to school following an acute concussion was associated with worse cognitive and physical symptoms, as well as a longer recovery time. 

The study participants who returned to school within one week of their injury had significantly worse cognitive and physical symptoms compared to those who returned to school after one week.The reasons for the association between early return to school and a more prolonged recovery are not fully understood.

It is believed that returning to school too soon may put additional stress on the brain and make it more difficult for the injury to heal. The cognitive demands of school may exacerbate symptoms, such as headache and fatigue, and make it more difficult for the child to focus and perform well in class.

Conclusion

The association between early return to school following acute concussion remains a controversial issue in the medical community. While some studies have shown that an early return to a modified school environment can have beneficial effects on the recovery process, others have highlighted the importance of a gradual and cautious approach in order to avoid exacerbating symptoms and prolonging recovery time. 

Ultimately, the decision to return to school should be made on a case-by-case basis, taking into consideration the individual’s symptoms and medical status, as well as the support available in the school environment. It is crucial that concussion management protocols are in place and followed in order to ensure the safety and well-being of all students.

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